| NPI | 1073576443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON E LISTER Owner/President 520-623-9479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 6045) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2020-08-22 |